School-based HIV/AIDS prevention programmes have been implemented in South Africa's coastal regions to address high prevalence rates among primary school students. These interventions aim to educate and empower young learners with knowledge about HIV/AIDS, its transmission, and preventive measures. A mixed-methods approach was employed, combining quantitative data from standardised pre- and post-programme assessments with qualitative insights through focus group discussions and teacher interviews to evaluate the impact of the HIV/AIDS prevention programmes on primary school students in South Africa's coastal regions over a five-year period. There is a consistent adoption rate of 95% for the HIV/AIDS prevention programmes across all schools, indicating high programme acceptance. However, learning outcomes varied significantly, with an average improvement score of 78% in knowledge retention post-programme implementation. The findings suggest that while the HIV/AIDS prevention programmes are well-received by students and teachers alike, there is room for enhanced educational strategies to improve understanding and retention of key HIV/AIDS-related information. Based on these results, it is recommended that further research be conducted to identify specific learning strategies that can enhance knowledge retention in HIV/AIDS prevention education. Additionally, the integration of community-based support mechanisms should be explored to supplement school-based programmes.